The Flow-Metabolic Phenotype of Primary Colorectal Cancer: Assessment by Integrated 18F-FDG PET/Perfusion CT with Histopathologic Correlation
The Flow-Metabolic Phenotype of Primary Colorectal Cancer: Assessment by Integrated 18F-FDG PET/Perfusion CT with Histopathologic Correlation
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DOI：
10.2967/jnumed.111.098525
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发表时间：
2012-05-01
影响因子：
9.3
通讯作者：
Groves, Ashley M.
中科院分区：
文献类型：
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作者：
Goh, Vicky;Engledow, Alec;Groves, Ashley M.
本研究的目的是用F-18-FDG PET/灌注CT评价原发性结直肠癌的体内血流代谢表型及其与血管生成和缺氧的金标准组织病理学评估的关系。方法：45例原发结直肠癌患者，男26例，女19例，平均年龄67.6岁，行F-18-FDG PET/CT灌注扫描，计算肿瘤的葡萄糖代谢(最大摄取值)和局部血流量。在这个队列中，35人随后接受了手术，没有介入新的辅助治疗，允许组织病理学与肿瘤分期、CD105微血管密度、血管内皮生长因子(VEGF)、葡萄糖转运蛋白1(Glut1)和低氧诱导因子1的表达相关。结果：高表达血管内皮生长因子(3.65 vs.5.98；P=0.01)或低氧诱导因子1(3.63 vs.5.48；P=0.04)的肿瘤与低表达的肿瘤相比，血流代谢比明显降低。肿瘤血流代谢比与血管内皮生长因子表达呈显著负相关(r=-0.55，P=0.0008)，提示低血流量、高代谢肿瘤与血管内皮生长因子高表达有关。在高分期(III/IV期)肿瘤中，血流与代谢耦合，而在低分期(I/II期)肿瘤中不耦合(r=0.47，P=0.03，r=0.09，P=0.65)。结论：低流量-高代谢表型的肿瘤有较高的血管内皮生长因子表达，可能反映了更多的血管生成表型。
The aim of this study was to assess the in vivo flow-metabolic phenotype in primary colorectal cancer with integrated F-18-FDG PET/perfusion CT and its relationship to gold standard histopathologic assessment of angiogenesis and hypoxia. Methods: 45 patients (26 male and 19 female; mean age, 67.6 y) with primary colorectal cancer underwent integrated F-18-FDG PET/perfusion CT, deriving tumor glucose metabolism (maximum standardized uptake value) and regional blood flow. From this cohort, 35 underwent surgery subsequently, without intervening neoadjuvant treatment, allowing histopathologic correlation with tumor stage, CD105 microvessel density, vascular endothelial growth factor (VEGF), glucose transporter protein 1 (Glut1), and hypoxia-inducible factor 1 expression. Results: The flow-metabolic ratio was significantly lower for tumors with higher VEGF (3.65 vs. 5.98; P = 0.01) or hypoxia-inducible factor 1 expression (3.63 vs. 5.48; P = 0.04) versus tumors with lower expression. There were significant negative correlations between the tumor flow-metabolic ratio and VEGF expression (r = -0.55, P = 0.0008), indicating that tumors with low blood flow but higher metabolism were associated with higher VEGF expression. Flow and metabolism were coupled in higher-stage (stage III/IV) tumors but not lower-stage tumors (stage I/II) (r = 0.47, P = 0.03, vs. r = 0.09, P = 0.65, respectively. Conclusion: Tumors with a low-flow-high-metabolism phenotype demonstrated higher VEGF expression and may reflect a more angiogenic phenotype.